This is a revised application of an R01 proposal (AA08528-OlAl) to study the effects of alcohol use during pregnancy on the neurophysiological development of the offspring at 6 and 8 years. Studies obtained on the same cohort in a previous study at birth through eighteen months will allow longitudinal analyses. Three neurophysiological measures will be used to explore the effect of prenatal alcohol exposure, including sleep architecture/continuity, sensory evoked responses, and peripheral/central auditory function. Four specific hypotheses will be examined: 1) there will be effects of prenatal alcohol exposure on sleep architecture and continuity, characterized by lowered sleep efficiency and maintenance, as well as excessive arousals; 2) prenatal alcohol exposure will affect the visual and auditory pathways as exhibited by delayed latencies and reduced amplitudes in evoked responses; 3) sensorineural hearing loss and central auditory processing dysfunction will be related to prenatal alcohol use; 4) these neurophysiological/otoneurological deficits will be manifested as disruptions in cognitive and behavioral skills of the child at school-age years. In an earlier study, neurophysiological measurements were analyzed at birth, one month, and three years of age. These data showed that prenatal alcohol exposure was associated with increased arousals, increased indeterminate sleep, decreased quiet sleep, and increased sleep-motility cycling in the newborn period. Prolonged latencies and reduced amplitudes of visual evoked responses were detected at 1 month. Finally, trends in the direction of lower sleep efficiency and maintenance, as well as increased awake time were observed at 3 years. The current study is designed to apply these previous findings to a second and larger cohort of children already identified at birth and followed through 18 months of age. We anticipate that effects on neurophysiological and otoneurological development will persist at older ages, as more complex demands are made on brain function. Physical and mental development, morphological anomalies, behavioral and neurological characteristics, substance use, environmental factors and psychological traits of the mother will also be assessed at six and eight years of age.